Table of ContentsView AllTable of ContentsAge of OnsetWarning SignsSymptomsDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Age of Onset
Warning Signs
Symptoms
Diagnosis
Treatment
The age whenschizophreniastarts is typically in the late teen years to the early thirties and tends to emerge earlier in males than females. Males are usually diagnosed in late adolescence to early 20s, while females are usually diagnosed in their early 20s to early 30s.Research suggests that a combination of genetics, environmental factors, and brain chemistry contribute to the development of this mental disorder. With the right treatments, you can manage your symptoms and live well.This article discusses when schizophrenia typically starts, its warning signs, and how it is treated.Verywell / Danie DrankwalterTypical Age of Onset for SchizophreniaSchizophrenia is typically diagnosed between 16 and 30 years old or after the first episode of psychosis occurs.This doesn’t mean symptoms necessarily start at this time, though.A person can experience prodromal (a period of early symptoms before full development of a condition) schizophrenia symptoms for weeks or years before being diagnosed. This first phase is hard to distinguish from the normal ups and downs of puberty or other mental disorders likedepressionand anxiety.There are a few theories about why schizophrenia tends to appear during late adolescence:Late adolescence is a critical period for brain development, making it particularly vulnerable to mental disorders.Underlying genetic variations or brain abnormalities may become more obvious during this developmental stage.Hormones interacting with central nervous system systems combined with environmental triggers, such as stress, may contribute to the development of schizophrenia.Experimental or regular use of psychoactive drugs during teen years like regular cannabis use before adulthood is associated with schizophrenia, but more research is needed to establish this cause-and-effect relationship.Early-Onset SchizophreniaEarly-onset schizophrenia (EOS) refers to schizophrenia that’s diagnosed before the age of 18, which has a prevalence of 0.5%.EOS is different from schizophrenia that develops before the age of 13, otherwise known as child-onset schizophrenia (COS). COS is rare, affecting around one in 40,000 children (0.04%).How Childhood Schizophrenia Is DiagnosedLate-Onset SchizophreniaLate-onset schizophrenia (LOS) is schizophrenia diagnosed after the age of 40. It typically develops during the menopausal years or between 44 and 49 years of age. Some research estimates that approximately 20% of people with schizophrenia have a late onset of the mental disorder, the majority of which are women (although it can also occur in men).Unlike EOS or COS, symptoms of LOS could also be prodromes (early symptoms) ofdementiaor other conditions. Furthermore, they could have been occurring to some degree for years before the person reached out for help, meaning the onset of symptoms may be quite difficult to accurately determine.How to Seek Help in a CrisisIf you or a loved one is struggling with schizophrenia, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.Early Warning Signs of SchizophreniaThe prodromal phase of schizophrenia can be particularly difficult to identify because it lacks the positive (psychotic) symptoms characteristic of active schizophrenia. For example, the first signs can include a change of friends, a drop in grades, sleep problems, and irritability—common and nonspecific adolescent behavior.Positive symptoms include hallucinations (perceiving things that aren’t there) and delusions (firmly held beliefs that are not true).In about 25% of patients, there will be no distinct prodromal phase.That’s not to say there aren’t early warning signs to watch out for; it’s just that they may be easily dismissed.Children are more likely to experience auditory hallucinations than adults. Children don’t usually develop delusions or thought distortions until mid-adolescence, though.Common early warning signs of schizophrenia include:Nervousness and restlessnessDepressionAnxietyThinking or concentration difficultiesLack of self-confidenceLack of energySignificant drop in grades or job performanceSocial isolation or uneasiness around other peopleLack of attention or care for personal hygieneEarly Signs and Symptoms of SchizophreniaSymptoms of SchizophreniaIt’s not exactly clear how schizophrenia develops, although physical, genetic, and environmental factors can all influence a person’s vulnerability to developing schizophrenia. A stressful or traumatic life event can also trigger a psychotic episode.Symptoms of schizophrenia include:HallucinationsDelusionsThought disorder (unusual ways of thinking)Reduced expression of emotionsReduced motivation to accomplish goalsDifficulty in social relationshipsMotor and cognitive impairmentDiagnosing of SchizophreniaYour doctor will use the criteria in the “Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition” to rule out other mental disorders and make a diagnosis. They may also order blood or imaging tests to eliminate physical conditions that could be causing your symptoms.Early Treatment of SchizophreniaEarly treatment usually involves medication, psychotherapy, and life skills training. Sometimes early treatment may start with a hospital stay if symptoms become severe enough that they threaten the safety of the child, adult, or anyone else.Some studies on the time between first episodes and schizophrenia diagnosis demonstrate the average is a year in developed countries and twice as long in developing countries.The Early Treatment and Intervention in Psychosis Study (TIPS) in Norway and Denmark included 281 people with primary psychotic disorders like schizophrenia.The researchers found that:Early detection was associated with significantly shorter duration of untreated psychosis (five weeks compared to 16 weeks for the non-early intervention group).Individuals in the early detection group were less symptomatic and had greater overall functioning.At the three-month follow-up, individuals in the early detection group had fewer negative and general symptoms.At two years, the early detection group still had lower levels of negative, cognitive, and depressive symptoms despite treatments being the same for both groups the whole time.SummarySchizophrenia typically appears in late adolescence and the early 20s. For males, the average age of onset is between late teens and early 20s, while it’s early 20s to early 30s for females. However, it can affect people of any age, and can also appear in your 40s, which is known as late-onset schizophrenia. Paying attention to the early signs of schizophrenia can help you detect this mental disorder and get treated sooner, which has been linked to better outcomes.
The age whenschizophreniastarts is typically in the late teen years to the early thirties and tends to emerge earlier in males than females. Males are usually diagnosed in late adolescence to early 20s, while females are usually diagnosed in their early 20s to early 30s.
Research suggests that a combination of genetics, environmental factors, and brain chemistry contribute to the development of this mental disorder. With the right treatments, you can manage your symptoms and live well.
This article discusses when schizophrenia typically starts, its warning signs, and how it is treated.
Verywell / Danie Drankwalter
Typical Age of Onset for Schizophrenia
Schizophrenia is typically diagnosed between 16 and 30 years old or after the first episode of psychosis occurs.This doesn’t mean symptoms necessarily start at this time, though.
A person can experience prodromal (a period of early symptoms before full development of a condition) schizophrenia symptoms for weeks or years before being diagnosed. This first phase is hard to distinguish from the normal ups and downs of puberty or other mental disorders likedepressionand anxiety.
There are a few theories about why schizophrenia tends to appear during late adolescence:
Early-Onset Schizophrenia
Early-onset schizophrenia (EOS) refers to schizophrenia that’s diagnosed before the age of 18, which has a prevalence of 0.5%.EOS is different from schizophrenia that develops before the age of 13, otherwise known as child-onset schizophrenia (COS). COS is rare, affecting around one in 40,000 children (0.04%).
How Childhood Schizophrenia Is Diagnosed
Late-Onset Schizophrenia
Late-onset schizophrenia (LOS) is schizophrenia diagnosed after the age of 40. It typically develops during the menopausal years or between 44 and 49 years of age. Some research estimates that approximately 20% of people with schizophrenia have a late onset of the mental disorder, the majority of which are women (although it can also occur in men).
Unlike EOS or COS, symptoms of LOS could also be prodromes (early symptoms) ofdementiaor other conditions. Furthermore, they could have been occurring to some degree for years before the person reached out for help, meaning the onset of symptoms may be quite difficult to accurately determine.
How to Seek Help in a CrisisIf you or a loved one is struggling with schizophrenia, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.
How to Seek Help in a Crisis
If you or a loved one is struggling with schizophrenia, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.
Early Warning Signs of Schizophrenia
The prodromal phase of schizophrenia can be particularly difficult to identify because it lacks the positive (psychotic) symptoms characteristic of active schizophrenia. For example, the first signs can include a change of friends, a drop in grades, sleep problems, and irritability—common and nonspecific adolescent behavior.
Positive symptoms include hallucinations (perceiving things that aren’t there) and delusions (firmly held beliefs that are not true).
In about 25% of patients, there will be no distinct prodromal phase.That’s not to say there aren’t early warning signs to watch out for; it’s just that they may be easily dismissed.
Children are more likely to experience auditory hallucinations than adults. Children don’t usually develop delusions or thought distortions until mid-adolescence, though.
Common early warning signs of schizophrenia include:
Early Signs and Symptoms of Schizophrenia
Symptoms of Schizophrenia
It’s not exactly clear how schizophrenia develops, although physical, genetic, and environmental factors can all influence a person’s vulnerability to developing schizophrenia. A stressful or traumatic life event can also trigger a psychotic episode.
Symptoms of schizophrenia include:
Diagnosing of Schizophrenia
Your doctor will use the criteria in the “Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition” to rule out other mental disorders and make a diagnosis. They may also order blood or imaging tests to eliminate physical conditions that could be causing your symptoms.
Early Treatment of Schizophrenia
Early treatment usually involves medication, psychotherapy, and life skills training. Sometimes early treatment may start with a hospital stay if symptoms become severe enough that they threaten the safety of the child, adult, or anyone else.
Some studies on the time between first episodes and schizophrenia diagnosis demonstrate the average is a year in developed countries and twice as long in developing countries.
The Early Treatment and Intervention in Psychosis Study (TIPS) in Norway and Denmark included 281 people with primary psychotic disorders like schizophrenia.The researchers found that:
Summary
Schizophrenia typically appears in late adolescence and the early 20s. For males, the average age of onset is between late teens and early 20s, while it’s early 20s to early 30s for females. However, it can affect people of any age, and can also appear in your 40s, which is known as late-onset schizophrenia. Paying attention to the early signs of schizophrenia can help you detect this mental disorder and get treated sooner, which has been linked to better outcomes.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Mental Health.Schizophrenia.Selemon LD, Zecevic N.Schizophrenia: a tale of two critical periods for prefrontal cortical development. Transl Psychiatry. 2015;5(8):e623-e623. doi: 10.1038/tp.2015.115Dick DM, Adkins AE, Kuo SI.Genetic influences on adolescent behavior. Neurosci Biobehav Rev. 2016 Nov;70:198-205. doi: 10.1016/j.neubiorev.2016.07.007Kulkarni J, Gavrilidis E, Worsley R.Hormones and schizophrenia. In: Handbook of Behavioral Neuroscience. Vol 23. Elsevier; 2016:463-480. doi: 10.1016/B978-0-12-800981-9.00027-4National Institute on Drug Abuse.Is there a link between marijuana use and psychiatric disorders?Petruzzelli MG, Margari L, Bosco A, Craig F, Palumbi R, Margari F.Early onset first episode psychosis: dimensional structure of symptoms, clinical subtypes and related neurodevelopmental markers.Eur Child Adolesc Psychiatry. 2018;27(2):171-179. doi:10.1007/s00787-017-1026-7Kendhari J, Shankar R, Young-Walker L.A Review of Childhood-Onset Schizophrenia. Focus (Am Psychiatr Publ). 2016 Jul;14(3):328-332. doi: 10.1176/appi.focus.20160007Maglione JE, Thomas SE, Jeste DV.Late-onset schizophrenia: do recent studies support categorizing LOS as a subtype of schizophrenia?Current Opinion in Psychiatry. 2014;27(3):173-178. doi:10.1097/YCO.0000000000000049Cohen CI.Very late-onset schizophrenia-like psychosis: positive findings but questions remain unanswered.The Lancet Psychiatry. 2018;5(7):528-529. doi:10.1016/S2215-0366(18)30174-3National Alliance on Mental Illness.Schizophrenia.National Institutes of Mental Health.Fact sheet: early warning signs of psychosis.Children’s National Hospital.Pediatric schizophrenia.Lieberman JA, Small SA, Girgis RR.Early detection and preventive intervention in schizophrenia: from fantasy to reality.AJP. 2019;176(10):794-810. doi:10.1176/appi.ajp.2019.19080865
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Mental Health.Schizophrenia.Selemon LD, Zecevic N.Schizophrenia: a tale of two critical periods for prefrontal cortical development. Transl Psychiatry. 2015;5(8):e623-e623. doi: 10.1038/tp.2015.115Dick DM, Adkins AE, Kuo SI.Genetic influences on adolescent behavior. Neurosci Biobehav Rev. 2016 Nov;70:198-205. doi: 10.1016/j.neubiorev.2016.07.007Kulkarni J, Gavrilidis E, Worsley R.Hormones and schizophrenia. In: Handbook of Behavioral Neuroscience. Vol 23. Elsevier; 2016:463-480. doi: 10.1016/B978-0-12-800981-9.00027-4National Institute on Drug Abuse.Is there a link between marijuana use and psychiatric disorders?Petruzzelli MG, Margari L, Bosco A, Craig F, Palumbi R, Margari F.Early onset first episode psychosis: dimensional structure of symptoms, clinical subtypes and related neurodevelopmental markers.Eur Child Adolesc Psychiatry. 2018;27(2):171-179. doi:10.1007/s00787-017-1026-7Kendhari J, Shankar R, Young-Walker L.A Review of Childhood-Onset Schizophrenia. Focus (Am Psychiatr Publ). 2016 Jul;14(3):328-332. doi: 10.1176/appi.focus.20160007Maglione JE, Thomas SE, Jeste DV.Late-onset schizophrenia: do recent studies support categorizing LOS as a subtype of schizophrenia?Current Opinion in Psychiatry. 2014;27(3):173-178. doi:10.1097/YCO.0000000000000049Cohen CI.Very late-onset schizophrenia-like psychosis: positive findings but questions remain unanswered.The Lancet Psychiatry. 2018;5(7):528-529. doi:10.1016/S2215-0366(18)30174-3National Alliance on Mental Illness.Schizophrenia.National Institutes of Mental Health.Fact sheet: early warning signs of psychosis.Children’s National Hospital.Pediatric schizophrenia.Lieberman JA, Small SA, Girgis RR.Early detection and preventive intervention in schizophrenia: from fantasy to reality.AJP. 2019;176(10):794-810. doi:10.1176/appi.ajp.2019.19080865
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Mental Health.Schizophrenia.Selemon LD, Zecevic N.Schizophrenia: a tale of two critical periods for prefrontal cortical development. Transl Psychiatry. 2015;5(8):e623-e623. doi: 10.1038/tp.2015.115Dick DM, Adkins AE, Kuo SI.Genetic influences on adolescent behavior. Neurosci Biobehav Rev. 2016 Nov;70:198-205. doi: 10.1016/j.neubiorev.2016.07.007Kulkarni J, Gavrilidis E, Worsley R.Hormones and schizophrenia. In: Handbook of Behavioral Neuroscience. Vol 23. Elsevier; 2016:463-480. doi: 10.1016/B978-0-12-800981-9.00027-4National Institute on Drug Abuse.Is there a link between marijuana use and psychiatric disorders?Petruzzelli MG, Margari L, Bosco A, Craig F, Palumbi R, Margari F.Early onset first episode psychosis: dimensional structure of symptoms, clinical subtypes and related neurodevelopmental markers.Eur Child Adolesc Psychiatry. 2018;27(2):171-179. doi:10.1007/s00787-017-1026-7Kendhari J, Shankar R, Young-Walker L.A Review of Childhood-Onset Schizophrenia. Focus (Am Psychiatr Publ). 2016 Jul;14(3):328-332. doi: 10.1176/appi.focus.20160007Maglione JE, Thomas SE, Jeste DV.Late-onset schizophrenia: do recent studies support categorizing LOS as a subtype of schizophrenia?Current Opinion in Psychiatry. 2014;27(3):173-178. doi:10.1097/YCO.0000000000000049Cohen CI.Very late-onset schizophrenia-like psychosis: positive findings but questions remain unanswered.The Lancet Psychiatry. 2018;5(7):528-529. doi:10.1016/S2215-0366(18)30174-3National Alliance on Mental Illness.Schizophrenia.National Institutes of Mental Health.Fact sheet: early warning signs of psychosis.Children’s National Hospital.Pediatric schizophrenia.Lieberman JA, Small SA, Girgis RR.Early detection and preventive intervention in schizophrenia: from fantasy to reality.AJP. 2019;176(10):794-810. doi:10.1176/appi.ajp.2019.19080865
National Institute of Mental Health.Schizophrenia.
Selemon LD, Zecevic N.Schizophrenia: a tale of two critical periods for prefrontal cortical development. Transl Psychiatry. 2015;5(8):e623-e623. doi: 10.1038/tp.2015.115
Dick DM, Adkins AE, Kuo SI.Genetic influences on adolescent behavior. Neurosci Biobehav Rev. 2016 Nov;70:198-205. doi: 10.1016/j.neubiorev.2016.07.007
Kulkarni J, Gavrilidis E, Worsley R.Hormones and schizophrenia. In: Handbook of Behavioral Neuroscience. Vol 23. Elsevier; 2016:463-480. doi: 10.1016/B978-0-12-800981-9.00027-4
National Institute on Drug Abuse.Is there a link between marijuana use and psychiatric disorders?
Petruzzelli MG, Margari L, Bosco A, Craig F, Palumbi R, Margari F.Early onset first episode psychosis: dimensional structure of symptoms, clinical subtypes and related neurodevelopmental markers.Eur Child Adolesc Psychiatry. 2018;27(2):171-179. doi:10.1007/s00787-017-1026-7
Kendhari J, Shankar R, Young-Walker L.A Review of Childhood-Onset Schizophrenia. Focus (Am Psychiatr Publ). 2016 Jul;14(3):328-332. doi: 10.1176/appi.focus.20160007
Maglione JE, Thomas SE, Jeste DV.Late-onset schizophrenia: do recent studies support categorizing LOS as a subtype of schizophrenia?Current Opinion in Psychiatry. 2014;27(3):173-178. doi:10.1097/YCO.0000000000000049
Cohen CI.Very late-onset schizophrenia-like psychosis: positive findings but questions remain unanswered.The Lancet Psychiatry. 2018;5(7):528-529. doi:10.1016/S2215-0366(18)30174-3
National Alliance on Mental Illness.Schizophrenia.
National Institutes of Mental Health.Fact sheet: early warning signs of psychosis.
Children’s National Hospital.Pediatric schizophrenia.
Lieberman JA, Small SA, Girgis RR.Early detection and preventive intervention in schizophrenia: from fantasy to reality.AJP. 2019;176(10):794-810. doi:10.1176/appi.ajp.2019.19080865
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